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Trainee Hcc Risk Adjustment Coding Jobs in Washington

CINQCARE

Sr. Director, Risk Adjustment (0778)

Washington, DC · On-site

$146K - $183K/yr

Certified Risk Adjustment Coder (CRC) or similar credential is a plus. Technical Skills: * Deep expertise in CMS-HCC, HHS-HCC, and CDPS risk adjustment models. * Advanced proficiency in Python and/or ...

HealthCare Resolution Services

Medical Coder

Columbia, MD · Remote

$19.25 - $25.50/hr

As an HCC Coding Analyst, you will play a vital role in ensuring accurate documentation and coding ... Understanding of the CMS guidelines for risk adjustment models and reimbursement policies.

Humana

Medical Coder Educator

Centreville, VA · On-site +1

$18.50 - $24.75/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder Educator

Fairfax, VA · On-site +1

$19.25 - $25.50/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder Educator

Springfield, VA · On-site +1

$19.50 - $26/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder Educator

Dale City, VA · On-site +1

$21 - $28.25/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder Educator

Dale City, VA · On-site +1

$21 - $28.25/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

Humana

Medical Coder Educator

Annandale, VA · On-site +1

$18.75 - $24.75/hr

Risk Adjustment knowledge * Familiar with coding guidelines * Live in NC, SC, GA, VA, MD or TN Preferred Qualifications * Bachelor's Degree * CRC -Certified Risk Adjustment Coder * Experience working ...

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Trainee Hcc Risk Adjustment Coding information

How to get into risk adjustment coding?

To become a Trainee HCC Risk Adjustment Coder, individuals typically need a high school diploma or equivalent, followed by completing specialized training or certification in risk adjustment coding, such as the AHIMA Certified Risk Adjustment Coder (CRC) credential. Gaining proficiency in medical coding, understanding of diagnosis coding systems like ICD-10, and familiarity with healthcare data are essential for entry-level roles in this field.

Is HCC coding a good career?

HCC risk adjustment coding is a growing field within healthcare, focusing on accurately documenting patient health conditions for insurance reimbursement and risk management. It requires knowledge of medical coding, attention to detail, and often certification, making it a stable career with demand across healthcare organizations. Many professionals find it a rewarding career due to its specialized nature and opportunities for remote work.

What are some common challenges faced by Trainee HCC Risk Adjustment Coders, and how can they be overcome?

Trainee HCC Risk Adjustment Coders often encounter challenges such as interpreting complex medical documentation, staying up-to-date with changing coding guidelines, and accurately assigning codes that reflect patients' true risk profiles. Overcoming these challenges involves continuous learning, seeking mentorship from experienced coders, and utilizing resources like coding manuals and online forums. Collaborating with clinical staff and participating in regular training sessions can also enhance accuracy and confidence in the coding process.

What is the difference between Trainee Hcc Risk Adjustment Coding vs Hcc Risk Adjustment Coder?

AspectTrainee Hcc Risk Adjustment CodingHcc Risk Adjustment Coder
CertificationsNone or entry-level certificationsCertified Professional Coder (CPC) or equivalent
Work EnvironmentTraining programs, supervised settingsIndependent coding in healthcare facilities
Job ResponsibilitiesLearning coding processes, assisting with documentationAccurate coding, claim submission, compliance

The main difference is that Trainee Hcc Risk Adjustment Coders are in training or entry-level roles, focusing on learning and assisting, while Hcc Risk Adjustment Coders are experienced professionals responsible for independent coding and compliance tasks.

What is a Trainee HCC Risk Adjustment Coder?

A Trainee HCC Risk Adjustment Coder is an entry-level professional who is learning how to review and assign medical codes for diagnoses in patient records, specifically for the Hierarchical Condition Category (HCC) risk adjustment model. This role involves training in medical coding standards, healthcare regulations, and compliance requirements to ensure accurate coding for insurance and Medicare/Medicaid reimbursement. Trainees typically work under supervision and are expected to develop a strong understanding of ICD-10-CM coding, clinical documentation improvement, and the principles of risk adjustment. The position is ideal for those starting a career in medical coding and offers a pathway to becoming a certified HCC coder.

What are the key skills and qualifications needed to thrive as a Trainee HCC Risk Adjustment Coder, and why are they important?

To thrive as a Trainee HCC Risk Adjustment Coder, you need a foundational understanding of medical coding, anatomy, and healthcare terminology, often supported by a relevant certification or coursework. Familiarity with ICD-10-CM coding systems, electronic health records (EHRs), and risk adjustment software is typically required. Strong attention to detail, analytical thinking, and effective communication are important soft skills in this role. These skills ensure accurate coding, which directly impacts proper reimbursement, compliance, and the quality of patient care data.

How much does a certified risk adjustment coder make?

A certified risk adjustment coder typically earns between $50,000 and $80,000 annually, depending on experience, certification level, and geographic location. Entry-level positions may start lower, while experienced coders with advanced certifications can earn higher salaries, especially in healthcare settings that emphasize accurate risk adjustment coding.

How much do HCC coders make in the US?

HCC risk adjustment coders typically earn between $50,000 and $80,000 annually in the US, depending on experience, certification, and location. Entry-level positions may start lower, while experienced coders with certifications like CPC or CCS can earn higher salaries, especially in healthcare hubs or with specialized skills.
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Trainee Hcc Risk Adjustment Coding jobs near you
Infographic showing various Trainee Hcc Risk Adjustment Coding job openings in Washington as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 17% Part Time, and 6% Contract. Highlights an 88% Physical, 5% Hybrid, and 7% Remote job distribution.

Risk Adjustment Coding Specialist II - Maryland

Astrana Health

Annapolis Junction, MD • On-site

$70K - $85K/yr

Other

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Risk Adjustment Coding Specialist II - Maryland

We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Maryland market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends, and opportunities for improved accuracy for our providers. You'll translate your findings into actionable insights, creating and delivering education to providers and practice leaders while navigating complex conversations. Additionally, you'll track and report on key performance metrics—such as HCC recapture rates, AWVs, and other KPIs, helping drive provider performance and overall program success. We are seeking candidates who have experience with provider education and at least 3-5 years of risk adjustment experience!

What You'll Do

  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
  • Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
  • Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and/or higher work volume than Risk Adjustment Coding Specialist I
  • Other duties as assigned.

Qualifications

  • Must reside in Maryland and be open to traveling to provider sites within Maryland and surrounding areas. Reliable transportation and valid Driver's License required
  • Certified Professional Coder (CPC) or CRC from AAPC
  • Certified Risk Adjustment Coder (CRC) certifications from AAPC
  • At least 3 years of experience in risk adjustment experience
  • At least 1 year experience with provider education
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborate
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding softwares and Electronic Health Records (EHR) systems.
  • Strong knowledge with PowerPoint, preparing presentations, and public speaking
  • Strong experience with Excel - reports, pivot tables, VLOOKUP, etc.

You're great for this role if:

  • Strong billing knowledge and/or Certified Professional Biller (CPB) through AAPC highly preferred
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Experience with multiple EMR/EHR systems
  • Experience with Monday.com and PowerBI
  • Ability to work independently and collaborate in a team setting
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting

Environmental Job Requirements and Working Conditions

  • This is a full-time position, operating M-F 830 AM - 5 PM EST.
  • The national target pay range for this role is $70,000 - $85,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
  • This role follows a hybrid work structure, where you will predominantly work remotely outside of quarterly travel to Maryland provider offices as needed.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

About Astrana Health, Inc.

Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.

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